• 제목/요약/키워드: standard hospital

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안와 전산화단층촬영검사 시 수정체 선량감소 방법과 영상 평가 (Lens Dose Reduction Methods and Image Quality in Orbital Computed Tomography Scan)

  • 문세영;홍상우;서지숙;김영범;곽완신;이성영;김정수
    • 대한방사선기술학회지:방사선기술과학
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    • 제43권5호
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    • pp.343-351
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    • 2020
  • This study analyzed dose reduction and quality of images through dose reduction tools and shielding board to protect sensitive eye lens in radiation during orbit CT examinations for clinical data use. During CT scans of the phantom, surface dose (CT scanner dosimetry phantom, ion chamber-3 times) and quality of image (radiosurgery head phantom, visual assessment-2 times, HU standard deviation) were evaluated using X-care which is dose reduction tools and bismuth shielding board. The results of experiments of eight conditions showed a relatively reduced dose in all other conditions compared to when no conditions were set. In particular, the area corresponding to the ophthalmic part reduced the surface dose by up to 45.7 %. The visual evaluation of images by specialists and the quality evaluation of images analyzed by HU standard deviation were clinically closest to the use of X-care and shielding board (1 cm in height). Therefore, it is believed that the use of shielding board in a suitable location with dose reduction tools while investigating the optimal radiation dose will reduce the exposure dose of sensitive lens at radiation while maintaining the quality of the images with high diagnostic value.

폐암 변증도구 개발을 위한 기초연구 (Preliminary Study to Develop the Instrument on Pattern Identification for Lung Cancer)

  • 김종민;전형준;박소정;김선영;조종관;정인철;유화승
    • 동의생리병리학회지
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    • 제28권6호
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    • pp.585-592
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    • 2014
  • This study is to develop a standard tool for pattern identifications in Korean Medicine for Lung Cancer. The advisor committee for this study was organized by 12 Korean Medicine professors from the Korean Association of Traditional Oncology. The item and structure of instrument were based on review of published literature. We took the consultation twice from the advisor committee and additional advices by e-mail correspondences. We divided the symptoms and signs of lung cancer into 6 pattern identifications. - lung spleen both deficiency (肺脾兩虛), lung kidney both deficiency (肺腎兩虛), dampness phlegm obstructing the lung (濕痰蘊肺), qi stagnation blood stasis (氣滯血瘀), yin deficiency toxin heat (陰虛毒熱), and heat toxin accumulation (熱毒蘊結). We obtained the mean weights which reflected the standard deviations from each symptoms of the 6 pattern identifications which were scored on a 5-point scale by 12 experts. We designed the Korean medicine pattern identification tool for lung cancer. It was composed of 57 questions in the question-and-answer format. Though there are some limits that this study is not proved about validity and reliability, the instrument is meaningful and expected to be applied to the subsequent research.

An integrated approach with homeopathic medicine and electro-acupuncture in anaesthesiology during breast cancer surgery: Case reports

  • Bosco, F;Cidin, S;Maceri, F;Ghilli, M;Roncella, M;De Simone, L
    • 대한약침학회지
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    • 제21권2호
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    • pp.126-131
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    • 2018
  • This study investigates the effect of a combination of homeopathic medicine and electro- acupuncture in two patients with breast cancer and severe liver disease who could not receive standard anaesthesia therapy due to liver problems. Specifically, measurable and quantifiable parameters were used to evaluate whether an integrated approach-consisting of electro- acupuncture and a homeopathic medicine diluted above Avogadro's limit (that is, above a potency of 12CH) during the pre-surgical, surgical and post-surgical phases -can improve general well-being of a patient undergoing breast cancer surgery. In breast cancer surgery, we employed an integrated approach consisting of induction with hypnotics and muscle relaxants, followed by maintenance with anaesthetic gas, combined with a homeopathic treatment (Arnica montana 15CH and Apis mellifica 15CH) before and after surgery and an electro- acupuncture treatment performed in the pre- and post-surgical phases without any analgesic/pain relieving medications. Both of the patients treated with the integrated approach improved their overall condition without need for other common pain relieving medicines. Additionally, thanks to their rapid awakening, the patients were not relocated to a protected area and the hospitalization was shorter. A multidisciplinary approach incorporating homeopathic medicine and electro-acupuncture can be a solution for patients who need or ask about a different and/or safer alternative to the standard treatment. This approach can offer a safe, much less expensive, non-invasive and viable alternative for such cases. Moreover it can be useful for an opioids free anesthesia.

Expression and Purification of a Functional Recombinant Aspartate Aminotransferase (AST) from Escherichia coli

  • Zou, Lihui;Zhao, Haijian;Wang, Daguang;Wang, Meng;Zhang, Chuanbao;Xiao, Fei
    • Journal of Microbiology and Biotechnology
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    • 제24권7호
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    • pp.998-1003
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    • 2014
  • Aspartate aminotransferase (AST; E.C. 2.6.1.1), a vitamin B6-dependent enzyme, preferentially promotes the mutual transformation of aspartate and ${\alpha}$-ketoglutarate to oxaloacetate and glutamate. It plays a key role in amino acid metabolism and has been widely recommended as a biomarker of liver and heart damage. Our study aimed to evaluate the extensive preparation of AST and its application in quality control in clinical laboratories. We describe a scheme to express and purify the 6His-AST fusion protein. An optimized sequence coding AST was synthesized and transformed into Escherichia coli BL21 (DE3) strain for protein expression. Ideally, the fusion protein has a volumetric productivity achieving 900 mg/l cultures. After affinity chromatography, the enzyme activity of purified AST reached 150,000 U/L. Commutability assessment between the engineered AST and standard AST from Roche suggested that the engineered AST was the better candidate for the reference material. Moreover, the AST showed high stability during long-term storage at $-20^{\circ}C$. In conclusion, the highly soluble 6His-tagged AST can become a convenient tool for supplying a much better and cheaper standard or reference material for the clinical laboratory.

Comparing Non-Communicable Disease Risk Factors in Asian Migrants and Native Koreans among the Asian Population

  • Piao, Heng;Yun, Jae Moon;Shin, Aesun;Cho, Belong;Kang, Daehee
    • Biomolecules & Therapeutics
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    • 제30권6호
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    • pp.603-615
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    • 2022
  • Assessing the health of international migrants is crucial in the Republic of Korea, Asia, and even worldwide. We compared the risk factors for non-communicable diseases among Asian migrants in Korea and the Korean population. This cross-sectional (2015) and longitudinal (2009-2015) observational study comprised a population-wide analysis spanning 2009 to 2015. Asian migrants (n=987,214) in Korea and Korean nationals (n=1,693,281) aged ≥20 were included. The Asian migrants were classified as Chinese, Japanese, Filipino, Vietnamese, and other. The prevalence of risk factors for non-communicable diseases (current smoking, obesity, diabetes mellitus, and hypertension) were analyzed. Regarding the age-adjusted prevalence, direct age standardization was conducted separately by sex using 10-year age bands; the World Standard Population was used as the standard population. Among the participants aged ≥20, the age-adjusted prevalence of current smoking was higher among Chinese and other Asian migrant men than among Korean men and women (p<0.001 and p<0.001, respectively). The age-adjusted prevalence of obesity was higher among Chinese, Filipino, and other Asian migrant women than in Korean women (p<0.001, p=0.002, and p<0.001, respectively). Among the participants aged 20-49, the age-adjusted prevalence of diabetes mellitus and hypertension was higher in Filipino migrant women than in Korean women (p=0.009 and p<0.001, respectively). Current rates of smoking and obesity were worse among Asian migrants of specific nationalities than among native Koreans. The health inequalities among Filipino migrant women in Korea, especially those aged 20-49, should be addressed.

Abdominal-based adipocutaneous advancement flap for reconstructing inguinal defects with contraindications to standard reconstructive approaches: a simple and safe salvage reconstructive option

  • Schaffer, Clara;Haselbach, Daniel;Schiraldi, Luigi;Sorelius, Karl;Kalbermatten, Daniel F.;Raffoul, Wassim;di Summa, Pietro G.
    • Archives of Plastic Surgery
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    • 제48권4호
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    • pp.395-403
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    • 2021
  • Background Groin wounds occurring after vascular surgical site infection, oncologic resection, or occasionally orthopedic surgery and trauma may represent a surgical challenge. Reconstruction of these defects by the usual workhorse flaps may be contraindicated following previous surgery and in patients with lower limb lymphedema or extreme morbidity. Methods This study included 15 consecutive patients presenting with inguinal wounds after vascular or general surgery that required debridement and soft tissue coverage. All cases had absolute or relative contraindications to conventional reconstructive techniques, including a compromised deep femoral artery network, limb lymphedema, scarring of potential flap harvesting sites, or poor overall condition. Abdominal adipocutaneous excess enabled the performance of adipocutaneous advancement flaps in an abdominoplasty-like fashion. Immediate and long-term outcomes were analyzed. Results Soft tissue coverage was effective in all cases. Two patients required re-intervention due to flap-related complications (venous congestion and partial flap necrosis). All patients fully recovered over a mean±standard deviation follow-up of 2.4±1.5 years. Conclusions Abdominal flaps can be an effective and simple alternative technique for inguinal coverage with reproducible outcomes. In our experience, the main indications are a compromised deep femoral artery network and poor thigh tissue quality. Relative contraindications, such as previous open abdominal surgery, should be considered.

약물부작용 감시를 위한 공통데이터모델 기반 임상데이터웨어하우스 구축 (Development and Lessons Learned of Clinical Data Warehouse based on Common Data Model for Drug Surveillance)

  • 노미정
    • 한국병원경영학회지
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    • 제28권3호
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    • pp.1-14
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    • 2023
  • Purposes: It is very important to establish a clinical data warehouse based on a common data model to offset the different data characteristics of each medical institution and for drug surveillance. This study attempted to establish a clinical data warehouse for Dankook university hospital for drug surveillance, and to derive the main items necessary for development. Methodology/Approach: This study extracted the electronic medical record data of Dankook university hospital tracked for 9 years from 2013 (2013.01.01. to 2021.12.31) to build a clinical data warehouse. The extracted data was converted into the Observational Medical Outcomes Partnership Common Data Model (Version 5.4). Data term mapping was performed using the electronic medical record data of Dankook university hospital and the standard term mapping guide. To verify the clinical data warehouse, the use of angiotensin receptor blockers and the incidence of liver toxicity were analyzed, and the results were compared with the analysis of hospital raw data. Findings: This study used a total of 670,933 data from electronic medical records for the Dankook university clinical data warehouse. Excluding the number of overlapping cases among the total number of cases, the target data was mapped into standard terms. Diagnosis (100% of total cases), drug (92.1%), and measurement (94.5%) were standardized. For treatment and surgery, the insurance EDI (electronic data interchange) code was used as it is. Extraction, conversion and loading were completed. R language-based conversion and loading software for the process was developed, and clinical data warehouse construction was completed through data verification. Practical Implications: In this study, a clinical data warehouse for Dankook university hospitals based on a common data model supporting drug surveillance research was established and verified. The results of this study provide guidelines for institutions that want to build a clinical data warehouse in the future by deriving key points necessary for building a clinical data warehouse.

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LI-RADS Version 2018 Treatment Response Algorithm: Diagnostic Performance after Transarterial Radioembolization for Hepatocellular Carcinoma

  • Jongjin Yoon;Sunyoung Lee;Jaeseung Shin;Seung-seob Kim;Gyoung Min Kim;Jong Yun Won
    • Korean Journal of Radiology
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    • 제22권8호
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    • pp.1279-1288
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    • 2021
  • Objective: To assess the diagnostic performance of the Liver Imaging Reporting and Data System (LI-RADS) version 2018 treatment response algorithm (TRA) for the evaluation of hepatocellular carcinoma (HCC) treated with transarterial radioembolization. Materials and Methods: This retrospective study included patients who underwent transarterial radioembolization for HCC followed by hepatic surgery between January 2011 and December 2019. The resected lesions were determined to have either complete (100%) or incomplete (< 100%) necrosis based on histopathology. Three radiologists independently reviewed the CT or MR images of pre- and post-treatment lesions and assigned categories based on the LI-RADS version 2018 and the TRA, respectively. Diagnostic performances of LI-RADS treatment response (LR-TR) viable and nonviable categories were assessed for each reader, using histopathology from hepatic surgeries as a reference standard. Inter-reader agreements were evaluated using Fleiss κ. Results: A total of 27 patients (mean age ± standard deviation, 55.9 ± 9.1 years; 24 male) with 34 lesions (15 with complete necrosis and 19 with incomplete necrosis on histopathology) were included. To predict complete necrosis, the LR-TR nonviable category had a sensitivity of 73.3-80.0% and a specificity of 78.9-89.5%. For predicting incomplete necrosis, the LR-TR viable category had a sensitivity of 73.7-79.0% and a specificity of 93.3-100%. Five (14.7%) of 34 treated lesions were categorized as LR-TR equivocal by consensus, with two of the five lesions demonstrating incomplete necrosis. Interreader agreement for the LR-TR category was 0.81 (95% confidence interval: 0.66-0.96). Conclusion: The LI-RADS version 2018 TRA can be used to predict the histopathologic viability of HCCs treated with transarterial radioembolization.

뇌졸중환자(腦卒中患者)에 있어서 치료경과(治療經過)에 따른 뇌혈류(腦血流) 변화(變化) - Brain SPECT 결과(結果)를 중심(中心)으로 - (The change of CBF(cerebral blood flow) of CVA patients by oriental medical treatment - Focused on Brain SPECT results -)

  • 강화정;홍석;김종석;송호천;범희승;전상윤
    • 대한한방내과학회지
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    • 제21권1호
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    • pp.39-45
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    • 2000
  • Object : SPECT which can visualize the distribution of CBF was operated to find the basic evidence by objective and scientific inspection on the fact that how the oriental medical treatment for stroke patients can effect CBF. Method : This study made 18 cases an object of research. These patients came to the Dongshin Univ. Oriental Medical Hospical within 5 days from the first attack, were diagnosed as stroke from Brain CT and MAl and were in the hospital for over 4 weeks at least. They were taken acupunture treatment, negative technique and herbal medication. And this study operated SPECT at the instance of admission and at the 4th week after admission 2 times and compared the change of CBF. Results : I operated SPECT on 18 CVA patients and got a result on the change of blood supplies in brain as follows; In the 2nd SPECT compared with 1st, out of the 1st and 2nd SPECT, there are 10 cases(55.6%) of increase and 8 cases (44.4%) of decrease. According to L/Cb11 evauation standard, the 1 st and the 2nd changes of blood supplies in SPECT shows decrese from $0.830{\pm}0.071$ to $0.801{\pm}0.067$. On the other hand, according to L/C standard shows a minute increase from $0.894{\pm}0.079$ to $0.895{\pm}0.091$. But there is nothing meaningful. I treated patients' group with risk factors and the other patients' group without risk factors and observed the changes of blood supplies respectively. And therefore Patients' group without risk factors shows an meaningful increase of blood supplies from $0.835{\pm}0.076$ to $0.796{\pm}0.069$ L/Cbll and also an increase from $0.921{\pm}0.029$ to $0.939{\pm}0.029$ by L/C. But this result by L/C is not significant. Conclusion : As mentioned above, I treated CVA patients through oriental medical therapies using SPECT and researched the changes of blood supplies in their brains. But I could' t get any meaningful result. However, I think only after solving some problems in this treatment and quantifing the changes of blood supplies, this results can be the standard of scientific examination about oriental medical treatments.

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Effect of IL-1 Polymorphisms, CYP2C19 Genotype and Antibiotic Resistance on Helicobacter pylori Eradication Comparing Between 10-day Sequential Therapy and 14-day Standard Triple Therapy with Four-Times-Daily-Dosing of Amoxicillin in Thailand: a Prospective Randomized Study

  • Phiphatpatthamaamphan, Kittichet;Vilaichone, Ratha-korn;Siramolpiwat, Sith;Tangaroonsanti, Anupong;Chonprasertsuk, Soonthorn;Bhanthumkomol, Patommatat;Pornthisarn, Bubpha;Mahachai, Varocha
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권4호
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    • pp.1903-1907
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    • 2016
  • Background: Studies of effects of IL-1 polymorphisms, CYP2C19 genotype together with antibiotic resistance for H. pylori eradication are rare worldwide. The present study was designed to evaluate efficacy of 10-day sequential therapy (SQT) and 14-day standard triple therapy (STT) with four- times-daily dosing of amoxicillin for H. pylori eradication related to these important host and bacterial factors in Thailand. Materials and Methods: This prospective randomized study was performed during March 2015 to January 2016. H. pylori infected gastritis patients were randomized to receive 10-day sequential therapy and 14-day standard triple therapy. CYP2C19 genotyping, IL1 polymorphism (IL-1B and IL-1RN genotypes) and antibiotic susceptibility tests were performed in all patients. 13C-UBT was conducted to confirm H. pylori eradication at least 4 weeks after treatment. Results: A total of 100 patients (33 males and 67 females, mean age=51.1 years) were enrolled. Eradication rate by PP analysis was 97.9% (47/48) with the 10-day SQT regimen and 87.8% (43/49) with 14-day STT regimen (97.9% vs 87.8%; p-value=0.053). Antibiotic susceptibility testing demonstrated 45% resistance to metronidazole, 14.8% to clarithromycin, and 24.1% to levofloxacin. CYP2C19 genotyping revealed 44.9% RM, 49% IM and 6.1% PM. IL-1B and IL-1RN genotypes were demonstrated as 21.4% for CC, 48.1% for TC, 36.8% for TT, 72.7% for 1/1, and 21.2% for 1/2 genotypes, respectively. The 10-day SQT regimen provided 100% eradication in patients with clarithromycin or dual clarithromycin and levofloxacin H. pylori resistant strains. Moreover, the 10-day SQT regimen resulted in a 100% eradication rate in all patients with CYP2C19 genotype RM and almost type of IL-1B (TC and TT) and IL1-RN genotypes ( 1/2 and other). Conclusions: Treatment with 10-day sequential therapy is highly effective for H. pylori eradication regardless of the effects of clarithromycin resistance, dual clarithromycin and levofloxacin resistance, CYP2C19 genotype, IL-1B and IL1-RN genetic polymorphisms and can be used as effective first line therapy in Thailand.